Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.81 / $83.27 / $149.18	Facility	26	$74.81	$83.27	$149.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.45 / $316.27 / $376.63	Professional		$220.45	$316.27	$376.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $129.57	Professional	26	$52.78	$61.64	$129.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.38 / $247.06 / $286.25	Professional	TC	$155.38	$247.06	$286.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $160.16 / $417.45	Professional		$143.31	$160.16	$417.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $53.92 / $109.88	Professional	26	$48.25	$53.92	$109.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.06 / $106.25 / $313.43	Professional	TC	$95.06	$106.25	$313.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $922.32 / $922.32 / $1,023.86	Professional		$922.32	$922.32	$1,023.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $463.36 / $463.36 / $463.36	Professional	26	$463.36	$463.36	$463.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $458.96 / $458.96 / $560.50	Professional	TC	$458.96	$458.96	$560.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $276.45 / $318.35 / $413.68	Professional		$276.45	$318.35	$413.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.81 / $105.72 / $123.52	Professional	26	$91.81	$105.72	$123.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.67 / $212.65 / $248.46	Professional	TC	$184.67	$212.65	$248.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $103.90 / $270.57	Professional		$32.34	$103.90	$270.57
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $304.52 / $358.26 / $413.69	Professional		$304.52	$358.26	$413.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $100.15 / $117.82 / $141.52	Professional	26	$100.15	$117.82	$141.52
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $204.37 / $240.44 / $272.17	Professional	TC	$204.37	$240.44	$272.17
United Facility/Professional Professional Modifier Low / Median / High Price $169.95 / $249.10 / $541.41	Professional		$169.95	$249.10	$541.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.63 / $62.44 / $117.65	Professional	26	$50.63	$62.44	$117.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.88 / $198.47 / $415.60	Professional	TC	$116.88	$198.47	$415.60